The typical and atypical MR imaging findings of central neurocytomas: Report on eighteen cases and review of the literature

Abstract

There were few studies have documented the MRI features of typical and atypical CNCs for diagnosis and therapeutic modalities. Here, 18 histopathologically confirmed cases of intracranial CNCs (8 men and 10 women with a mean age of 28.3 years, range 10-64 years) were retrospectively analyzed. The histopathological and immunohistochemical features were also assessed. On MR imaging, the 14 typical cases of CNCs showed relatively round, lobulated tumor masses in the body of the right lateral ventricle (5 cases), left lateral ventricle (4 cases), third ventricles (2 cases), and midline (3 cases). These typical CNCs masses contained clusters of cysts of varying sizes and "soap bubble" appearance on T2WI; they showed mild to moderate heterogeneously enhancement on T1WI. The 4 atypical cases of CNCs showed as strongly contrast enhancement of the tumors with the attachment or infiltrate of the wall of the ventricle than the typical benign cases. These atypical CNCs were in the right lateral ventricle (2 cases), left lateral ventricle (1 case), and third ventricle (1 case). Microscopically, the typical CNCs were well-differentiated tumors with benign histological features. The typical and atypical CNCs were composed of uniform, small to medium-sized cells with rounded nuclei and scant cytoplasm. Immunohistochemically, the typical CNCs were strong in Syn immunopositive (14/14) and neuron-specific enolase (12/14). The atypical CNC tumor cells showed malignant behavior and more positive expression of Ki67 than the benign cases. Surgery is the first choice of treatment, and radiotherapy may be beneficial to postoperative patients.

Keywords: Brain tumors; Immunohistochemistry; Intracranial central neurocytomas (CNCs); Magnetic resonance imaging (MRI); Pathology.